4th ARoFIIN ROUNDTABLE 26 JULY 2018

SUMMARY REPORT

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The Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN) hosted the 4th instalment of its Annual Roundtable in Jakarta, Indonesia. ARoFIIN’s progress over the past three years and discussions on scaling up partnerships through local collaborations to implement country-level solutions in response to the region’s growing non-communicable disease burden, were held.

This year’s Roundtable on “Embracing Uncommon Collaborations for a Healthy Asia” brought together over 60 senior leaders from various sectors across the region, including members from the Ministries of Health, the President’s Office of Indonesia, World Health Organisation (WHO) Country Office, UNICEF, World Food Programme, the Indonesian Nutrition Association, Academia, Non-Governmental Organisations (NGOs) and the food industry. Throughout the dialogue, there was a strong emphasis on working collectively to accelerate country-level initiatives across sectors to combat the growing public health challenges in the region.

Propelled by the successful launch of the report on “Tackling Obesity in ASEAN: Prevalence, impact, and guidance on interventions” and a series of follow-up workshops in several Asian countries that identified tailored interventions to improve health in children - the Roundtable also showcased two pilot initiatives. These two initiatives (detailed in this report) will be driven collectively by various stakeholders in Indonesia led by the United Nations World Food Programme and Thailand spearheaded by Mahidol University and the Thai Food and Drug Administration (TFDA), respectively.

This report provides a summary of the key highlights from the 4th Roundtable Dialogue. These takeaways will help shape ARoFIIN’s strategy moving forward, along with the themes for next year’s Roundtable session – developing localised solutions to end all forms of malnutrition in Asia.

We look forward to driving these multi-stakeholder dialogues further in 2018 and beyond. See you at the 5th Roundtable Dialogue next year!

Yours Sincerely,

ARoFIIN Secretariat

EXECUTIVE SUMMARY

SPEAKERS

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SPEAKERS

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SPEAKER HIGHLIGHTS

PHYSICAL ACTIVITY: AN UNDER UTILISED TOOL TO TACKLE THE DUAL BURDEN OF MALNUTRITION

Andrew Hiils Associate Dean, Global and Professor of Sports and Exercise Science University of Tasmania

“Too often, disconnected approaches mean that economies of scale cannot be applied- it is the responsibility of all, not that of one sector or agency, to influence healthy lifestyles within a population

INTRODUCING “NUTRI-TEACHER“ IN THAILAND

Araya RojjanawanicharkornConsultant, Thai Food and Drug Administration (TFDA)

“The key role in driving nutrition education within the community is by sharing and implementing their learnings on healthy behaviours with their families, creating a cycle for demand generation and strengthening nutrition literacy.”

PROVIDING ACCESS TO NUTRITIOUS FOODS IN ELEMENTARY SCHOOL IN INDONESIA

Diandra Pratami Government Partnerships Officer, World Food Programme (WFP), Indonesia

“All of WFP’s work in Indonesia is to support the Government’s own programme to achieve its development targets. Together, we leverage the meal not only as a source of nutrition, but also as an economic opportunity for local family farmers. We foster sustainable school feeding supply chains and at the same time promote nutritious, balanced diets to the school children, teachers, and the cooks whose are mostly mothers.”

WELCOME ADDRESS

Adhi Lukman Chairman, Indonesia Food & Beverages Association (GAPMMI)

“A platform that enables open and honest discussions between stakeholders across sectors is imperative to improve the health status in Asia. It is important that we work closely with local stakeholders to deliver country-level solutions in response to the health challenges threatening Asia.”

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A YEAR IN REVIEW: MOVING FORWARD WITH ARoFIIN

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HIGHLIGHTS FROM THE ROUNDTABLE

DISCUSSIONS & PANELS

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No longer described as a disease of affluence but rather as one of the biggest public health challenges, the prevalence of obesity has expanded to developing countries, across all income levels.

The roundtable discussions on cross-sector partnerships, sought to understand the pressure points that each sector had encountered to tackle obesity in Southeast Asia and explore multi-stakeholder solutions for the identified pressure points and opportunities to drive a positive shift in consumer behaviour and therefore reducing the rates of obesity in the region.

CHALLENGES FACED WITHIN EACH SECTOR:

» Lack of nutrition knowledge and awareness among consumers » Lack of consumer awareness on healthier choice/reformulated products » Lack of supporting research that reflect health status and local consumer eating and lifestyle

habits to support policy development » Budget limitations for R&D and country-wide research for data collection

CROSS-SECTOR PARTNERSHIPS: CHALLENGES AND OPPORTUNITIES TO COMBAT OBESITY

» Develop local data on consumer health and consumption habits to underpin policies developed on a country-level

» Work collectively with the government and the industry to build resources to promote nutrition education to the community

» Improve health literacy among consumers through nutrition education campaigns in schools and via digital media

» Provision of fiscal incentives (such as monetary grants or; raising the profile of the “service/product” delivered to end user)

» Multi-sectoral engagements to establish common goals across agencies

» Coordinated approach by respective agencies in the ministries is needed to develop customised interventions for the community

» Gain local government expertise while also referring to global case-studies and best-practices in policy development to tackle Asia’s health challenges

AREAS FOR COLLABORATION

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PANEL DISCUSSION ADDRESSING HIDDEN HUNGER IN INDONESIA

Asia has been challenged with the growing disease burden of malnutrit ion, with the increase in obesity rates, and the staggering prevalence of stunting, wasting and micronutrient deficiencies. This panel discussion addressed the concept of hidden hunger, focusing on the causes of undernutrit ion in Asia, with a particular focus on Indonesia. The proportions of over- and undernourished children in Indonesia are the same, with 12% of them suffering from muscle wasting and being overweight. On average, Indonesians consume twice as much cereals and less than half the recommended daily allowance of fruit and vegetables. The lack of protein in their diets has also contributed to the high stunting prevalence in its population.

Key experts on the panel discussed the need for strong polit ical commitment to initiate and sustain nutrit ion intervention programmes. They also emphasised on the importance to couple nutrit ion education alongside a social and behavioural change strategy to effectively improve physical activity alongside eating behaviours, consumer attitudes towards health, and highlighted that as a next step, the food environment should also be improved to create a sustainable solution in tackling malnutrit ion.

Through this discussion, it was established that there was a lack of understanding and polit ical wil l to tackle hidden hunger, poor consistency in implementing and sustaining nutrit ion intervention programmes and unequal efforts and miscommunication in multi-stakeholder partnerships that challenge the effectiveness of such programmes.

(From Left to Right)Rina Agustina, Chair of Human Nutrition Research Cluster, Faculty of Medicine, Universitas Indonesia (Moderator)Pungkas Ali, Director, Public Health and Nutrition, Ministry of National Development Planning, Indonesia (BAPPENAS)Jee Hyun Rah, Chief of Nutrition, UNICEF IndonesiaAtmarita, Head of Research and Publication, Indonesian Nutrition Association (PERSAGI)

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KEY TAKEAWAYS

Multi-stakeholder partnersips are built on the shared responsibility undertaken by the respective partners involved in the partnership. A strong political commitment and an in-depth understanding of the targeted issue are needed to drive efforts to combat malnutrition without which, nutrition interventions would be minimally impactful, at best.

To deliver sustainable solutions through nutrition education, social and behavioural change models and the food environment, particularly with regards to adolescents, is imperative to break the cycle of malnutrition in Indonesia.

PANEL DISCUSSIONFOOD INNOVATION AND THE ROLE OF MULTI-STAKEHOLDER

PARTNERSHIPS IN PROMOTING A HEALTHY ASIA

Consumer trends fundamentally drive product innovation and reformulation efforts. This panel discussion explored the current trends in food innovation that can nudge consumers towards healthier eating behaviours and addressed the challenges that have been associated with such innovations and how these can be overcome, by taking on a collective approach. With consumer trends evolving with time, the current demands revealed that consumers are making an effort to consume more fruits and vegetables, protein-rich foods including plant-based alternatives, while reducing the intake of sugar in their diets.

The panellists highlighted that, there was a clear shift in consumer demand for more nutritionally-balanced products. Yet, healthy products are less affordable to the common folk and food choices located near homes or offices are not always healthy. Through innovation and technological advancements- with the development of functional ingredients and/or by optimising food delivery through algorithms, tasty and nutritious products can be made affordable and easily accessible for all.

However, the common challenges associated with driving healthier product innovation and reformulation efforts include, budget limitations, ensuring consumer acceptability, maintaining taste profile and the lack of harmonisation in standards for new ingredients and technologies that can potentially deliver better nutrition to the consumer.

It was also agreed that promoting a healthier Asia is the responsibility that has be undertaken by all– individual, industry, academia (applicable research) government (policy) and non-governmental organisations.

(From Left to Right)

Kalpana Bhaskaran, Domain Lead, Applied Nutrition & Glycemic Index Research, School of Applied Science, Temasek Polytechnic (Moderator)Barnabas Chan, Chief Executive Officer, BountifoodStefanus Indrayana, Deputy Secretary General, GAPMMICasper Sermsuksan, Co-Founder & Chief Excitement Office, Kulina

Nutrition education along with wider availability and accessibility of nutritionally balanced options can shape consumer eating habits and influence a positive shift in their eating behaviours. Industry efforts around healthier product innovation and reformulation are continuous, and often takes place behind closed doors. These efforts can be strengthened through collaborations across sectors including governments and the academia to support nutrition education campaigns, policy frameworks and fiscal incentives that can accelerate the industry to stay ahead of the ever-changing consumer landscape.

KEY TAKEAWAYS

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(From Left to Right)

Kalpana Bhaskaran, Domain Lead, Applied Nutrition & Glycemic Index Research, School of Applied Science, Temasek Polytechnic (Moderator)Barnabas Chan, Chief Executive Officer, BountifoodStefanus Indrayana, Deputy Secretary General, GAPMMICasper Sermsuksan, Co-Founder & Chief Excitement Office, Kulina

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INSIGHTS INTO ARoFIIN

PILOT PROGRAMMES

As part of its scaling-up efforts, WFP with support from ARoFIIN, aims to increase the consumption of fruits and vegetables in one elementary school in the West Java Province of Indonesia by improving the nutrition education materials that embeds WFP’s effort in supporting the national school meals programme implementation.

The partnership will focus on the following areas: » Strengthening and/or developing nutrition education resources that emphasise the

importance and the promotion of fruits and vegetables under the ProGas guidelines and behaviour change campaigns of the Ministry of Education.

» Training and socialization of materials to pilot school and local government

» Implementation and monitoring progress

This partnership will form an integral part of the overall partnerships that WFP has, to support the National School Meals Programme. The Government of Indonesia (Ministry of Education) is the primary partner for this project with significant national budget provided, to cover the cost of the meals in schools.

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BACKGROUNDHigh rates of stunting, wasting, and the increased prevalence of overweight and obesity can be found in all wealth quintiles of Indonesia’s population, from the poorest to the wealthiest, particularly in children. Evidence shows that Indonesians do not follow a balanced diet: on average, they consume twice as much cereals and less than half the recommended daily allowance of fruit and vegetables.

To address this and other health concerns, Joko Widodo, President of Indonesia had launched the Healthy Indonesia Movement (Gerakan Masyarakat Indonesia Sehat or GERMAS) - a campaign managed by the Ministry of Health to promote a preventative approach to health. Part of the campaign seeks to change health behaviours within the population and a key element within this is the “My Plate” campaign, which il lustrates the proportion of carbohydrate, protein, vegetables and fruit each meal should contain.

As such, to improve the current nutrition conditions in Indonesian schools, the Ministry of Education has embarked on scaling up the coverage of the National School Meals programme (ProGas) from 11 districts in 2017 to 64 districts in 2018 with three main components in the programme, including provision of meals, nutrition education and health behaviour change. Targeted schools were selected based on the prevalence of stunting in the district.

The World Food Programme (WFP) had been tasked to support the scaling up of ProGas and the government’s capacity to implement, monitor and evaluate the national school meals programme.

Another fundamental role of WFP in the national school meal programme is to promote the consumption of fruit and vegetables in Indonesian school children, as part of their school breakfasts. With ProGas, children from low income households, gain access to nutritious food in schools and also learn the key principles around nutrition and how it has an impact on education quality and learning achievements in school.

INCREASING ACCESS TO NUTRITIOUS FOODS IN ELEMENTARY SCHOOLS IN INDONESIAA Partnership with the World Food Programme (WFP) and the Indonesian Government

THE COLLABORATION

This initiative targets the community, in which school children play important role in evaluating their and their family members’ healthy behaviours.

Proposed collectively by Mahidol University and the Thailand Food and Drug Administration (FDA) the “Nutri-Teacher” seeks to enhance communications on nutrition in schools. Using a two-step model, school children are required to do a self-evaluation based on their nutrition knowledge and healthy behaviours they adopt, alongside an anthropometric assessment prior to the introduction of interactive nutrition education materials, to expand their knowledge and behaviours on nutrition.

The data obtained through the self-evaluation together with the anthropometric measurements will be used to assess and monitor the health behaviours of an individual, family, school community, workplace environment and beyond.

The scores of the assessment can also be: » Used as a hands-on learning tool for children and community to better understand

nutrition concepts » Used in the development of health policies, from the derived statistics to advocate for a

healthy community.

The self-assessment checklist which forms the core of the initiative is a multi-purpose tool, tailored to improve nutrition education within and outside the school environment. Besides ARoFIIN support in facilitating the development of the programme, this partnership will also foster other stakeholders such as the Thai National Food Committee, Thai Health, the Ministry of Health and food industry partners to scale up the intervention, to strengthen the nutrition literacy and awareness on the preventive measures to the growing public health challenges.

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BACKGROUNDWith increased urbanization, reduced malnutrition, and a longer life expectancy, Thailand has seen a substantial increase in overweight and obesity incidence with 8.5% of adults in Thailand classed as obese. The overweight prevalence among adults has also increased by nearly 10% between 1995 and 2009. Cardiovascular diseases and stroke were identified as the leading causes of death in the country by 2011 as a result of the growing overweight/obesity prevalence.

With the numbers escalating quickly, the Thai government has been actively involved in raising public awareness across sectors on the risks of obesity, its co-morbidities and ways to curb it, through public health campaigns and interventions. As a country that has been quite successful with universal health care programs, nutrition education is recognized as an important tool for sustainably promoting nutrition.

The “Nutri-Teacher” programme aims to shape students as the agents of change for a healthy community by educating and enabling them to promote healthy eating and lifestyle behaviours to their peers and families which will then translate to community action. As the students become more knowledgeable, self-assessment and self-monitoring can occur within individuals, families and communities.

“NUTRI-TEACHERS” IN THAILANDA Partnership with Mahidol University and Thai Food and Drug Administration (TFDA)

THE COLLABORATION

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AUDIENCE PROFILE

AUDIENCE BREAKDOWN BY SECTOR

AUDIENCE BREAKDOWN BY SENIORITY

60 DELEGATESATTENDED

13%

16%

33%

29%

9% Academia

Government Bodies

Industry

NGOs/IGOs

Start-ups

6%

27%

16%9%

13%

18%

11% CEO/Co-Founder

Director

Executive

Head of Department

Manager

Academia

Others

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ASIA ROUNDTABLE ON FOODINNOVATION FOR IMPROVED NUTRITION (ARoFIIN)The Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN) was inaugurated in January 2015.

The Roundtable was set up, and convened by the Health Promotion Board (HPB), an agency of the Ministry of Health, Singapore, Academy of Science Technology and Research (A*STAR), Singapore Institute for Clinical Sciences (SICS) and Food Industry Asia (FIA), to leverage public-private partnerships by gathering experts from across government, academia, industry and civil societies to initiate and sustain a regional, multi-stakeholder dialogue to tackle malnutrition, obesity and chronic diseases.

Made up of a diverse network of stakeholders from across sectors, ARoFIIN seeks to foster a collaborative forum to support dissemination of science-based information on the drivers of obesity and chronic diseases, while also addressing the barriers and enablers to develop partnerships in the region.

Acting as a catalyst for multi-stakeholder action, ARoFIIN also works with stakeholders to stimulate scalable, cost-effective multi-stakeholder strategies for a healthy and prosperous Asia by driving a positive change in consumer behaviour and innovation.

www.ARoFIIN.org